Providers requesting Enhanced Care Management (ECM) services are now required to submit an ECM referral form. Previously, providers submitted a Prior Authorization Request (PAR) form for ECM services to our Utilization Management Department for review.
To request ECM
Submit one of these forms (depending on the member’s age):
- For patients 21 and up: ECM Adult Referral Form
- For patients under 21: ECM Child/Youth Referral Form
To speed up processing time, type directly into the form and submit it via secure email to [email protected]. Do not use a scanner, fax the form or fill in the form by hand. Watch our new tutorial video on the required forms, submission process and more.